Oral Candidiasis Mimicking Mucosal Lesions of Bullous Pemphigoid During Systemic Corticosteroid Therapy: A Case Report.

Bullous pemphigoid (BP) is an autoimmune blistering disorder mainly affecting the elderly. Although primarily cutaneous, bullous pemphigoid can occasionally involve the oral mucosa, which complicates diagnosis and management. We report an 88-year-old woman with diabetes and dementia who presented with tense bullae on her limbs. Systemic corticosteroid therapy improved the skin lesions, but new painful erosions appeared on the hard palate. Although mucosal BP was considered, the concurrent improvement of cutaneous symptoms suggested an opportunistic infection instead. Culture confirmed Candida albicans, and antifungal therapy led to rapid resolution. This case highlights the diagnostic challenge of distinguishing between BP progression and steroid-induced candidiasis. Early detection and proper treatment are essential, especially in elderly, immunocompromised patients. Maintaining oral hygiene through dental collaboration also plays a crucial role in preventing such complications. Our findings underscore the importance of multidisciplinary care and managing infection when treating BP in patients with systemic vulnerabilities. Key words:Bullous pemphigoid, Oral candidiasis, Elderly patient with diabetes.